Letters

The prescribing information for sotalol does not warn of the risk of life-threatening cardiogenic shock when this drug is used in patients with left ventricular dysfunction, and should probably be amended.

Simon D Leslie

Not enough women are being informed about the need for supplementation with iodine by their antenatal care providers.

Karen E Charlton · Creswell J Eastman AM

To the Editor: We are concerned by conclusions drawn by Del Mar and colleagues,1 in stating that because some autopsy studies have claimed more than 50% prevalence of latent prostate cancer in men aged over 60 years, this could be considered normal, and that these latent cancers result in a high level of overdiagnosis of prostate cancer. The study cited was conducted at Wayne State University, ...

Paul R McKenzie · Brett Delahunt · James G Kench

To the Editor: Recent articles in the Journal evaluating the evidence on screening for early-stage prostate cancer1,2 failed to mention one of the most important pieces of evidence ever published on the treatment of prostate cancer.3 This randomised controlled trial (RCT) showed that, compared with observation, radical prostatectomy did not significantly reduce all-cause or prostate cancer mortality over at least 12 years among men with clinically ...

Ian E Haines

To the Editor: We read with interest Del Mar and colleagues’ “re-examination” of the evidence for prostate cancer screening.1 Rather than presenting a balanced view, they have pursued a lopsided and flawed review of the data. First, they have given equal weighting to the results of the screening trials from Europe (ERSPC [European Randomized Study of Screening for Prostate Cancer]) and North America (PLCO [Prostate, Lung, ...

Nathan Lawrentschuk · Declan G Murphy · Anthony J Costello

In reply: We wish to make some comments in response to Haines’s point that the PIVOT (Prostate Cancer Intervention Versus Observation Trial) failed to show any benefit from radical prostatectomy (RP) over surveillance. First, in the PIVOT, a benefit of RP in terms of reduced all-cause mortality was suggested in men with a prostate-specific antigen (PSA) level > 10 ng/mL and in men with intermediate- and high-risk prostate ...

Jonas Hugosson · Sigrid V Carlsson

In reply: We thank Lawrentschuk and colleagues for the critical response. We would like to respond to several wrong assertions: We did not give equal weighting to the results of the ERSPC (European Randomized Study of Screening for Prostate Cancer) and the PLCO (Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial). Standard meta-analysis practice is to weight studies by the inverse variances of their effect estimates.1 ...

Chris B Del Mar*

To the Editor: The United States National Lung Screening Trial demonstrated a 20% reduction in lung cancer deaths among smokers screened with three low-radiation-dose computed tomography scans at yearly intervals. Hew and colleagues recently outlined the challenges in implementing such a screening program in Australia.1 However, the potential for saving lives is enormous. Currently only 14.1% of lung cancer patients survive 5 years — a marginal improvement ...

Paul L R Mitchell · Thomas John

In reply: We welcome the opportunity to respond to correspondence from Marshall and colleagues and Mitchell and colleagues about the impact of the National Lung Screening Trial (NLST)1 on three distinct issues: (i) current medical practice; (ii) developing public health policy; and (iii) implementation of future screening. Current medical practice: We do not currently recommend community screening. In the absence of resourced, educated, and coordinated referral ...

Mark Hew · Robert G Stirling · Michael J Abramson

To the Editor: Since the Henry tax review recommended broadening the base of the goods and services tax (GST),2 there have been rumours that the current exemption for fresh foods, such as fruits and vegetables, might be removed.2 Changes in government are often accompanied by a review of policies, and broadening the tax base is appealing because it would increase efficiency and raise revenue. But ...

J Lennert Veerman · Linda J Cobiac

To the Editor: We thank Hoad and colleagues for presenting data from Australian states and territories regarding in-flight exposure to measles.1 The current cases in Queensland, Victoria and New South Wales, which have included domestic air travel,2 highlight the challenges measles still holds for Australia. Hoad et al’s report outlines the substantial public health response that such air travel events generate, despite the low likelihood of ...

Stephen B Lambert · Frank H Beard